20604

Aspiration and/or injection of fluid from small joint using ultrasound guidance

Medicare pricing data for 6,653 providers across 52 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Aspiration and/or injection of fluid from small joint using ultrasound guidance (HCPCS code 20604) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $75.63, but hospitals typically charge $295.30 — a 3.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$15.13

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $75.63, your out-of-pocket cost would be approximately $15.13. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$75.63
Average Hospital Charge
$295.30
Markup Ratio
3.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$295.30
Medicare Allowed$75.63
Medicare Payment$57.00

Hospitals charge 3.9x more than what Medicare allows for this procedure. Medicare actually pays $57.00 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$94$2521895+24.2%
Alaska$93$54318130+23.3%
New Jersey$89$4862511,803+17.1%
Delaware$88$27615337+16.2%
Hawaii$85$1921127+12.1%
Connecticut$84$37260388+11.1%
California$84$2716025,409+10.7%
New York$84$4074563,198+10.4%
Maryland$79$2031431,256+4.2%
Colorado$78$299129860+3.6%
Florida$78$2294957,757+3.1%
Massachusetts$77$5051461,436+1.6%
Louisiana$76$25839288+0.1%
Rhode Island$76$28831439+0.1%
North Carolina$76$2551701,098-0.0%
Illinois$75$3122681,581-0.2%
Nevada$75$33862579-0.3%
Georgia$75$3371511,000-0.7%
Washington$75$230162632-1.3%
Oregon$75$27598655-1.3%
Pennsylvania$75$3183412,186-1.3%
South Carolina$75$3071151,423-1.3%
Michigan$74$1962071,226-1.8%
Virginia$74$2542101,791-1.8%
South Dakota$74$32044468-1.8%
Arizona$74$2452262,216-2.1%
Texas$74$3023812,874-2.6%
Wyoming$73$34712104-2.9%
Mississippi$73$34146869-3.1%
Indiana$73$271115936-3.5%
New Mexico$71$17748404-5.9%
Arkansas$71$19838227-6.1%
Puerto Rico$71$791024-6.3%
Alabama$69$15284549-8.1%
New Hampshire$69$32635483-8.4%
Kansas$68$25053365-9.6%
Ohio$68$2602381,188-10.3%
Missouri$68$259109737-10.4%
Minnesota$67$4421841,220-11.0%
Oklahoma$67$15842511-11.3%
Kentucky$67$20455311-11.6%
Utah$67$205126971-11.6%
Tennessee$67$239153992-12.0%
Vermont$65$201750-13.9%
Maine$65$20535187-14.1%
Wisconsin$65$570144936-14.3%
Montana$62$24421430-17.4%
West Virginia$62$2032098-18.2%
Iowa$61$41252451-18.7%
Nebraska$61$22642143-19.9%
North Dakota$54$3151595-28.7%
Idaho$53$19274443-30.1%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber